BRS-Assessed Resilience, Symptom Burden, and Functional Burden in Adolescents With Depressive, Anxiety, or Somatic Symptom-Related Disorders: A Single-Center Real-World Cross-Sectional Study.

BACKGROUND

Adolescents with depressive, anxiety, and somatic symptom-related disorders often present with overlapping symptom domains and functional difficulties, but cross-sectional associations of Brief Resilience Scale (BRS) score with multidimensional symptom and functional burden in routine outpatient care remain insufficiently characterized.

METHODS

This single-center, real-world, cross-sectional study retrospectively analyzed routinely collected data from adolescents aged 12-18 years attending a psychological/psychiatric outpatient clinic between January 2024 and December 2025. Eligible patients had clinician-recorded depressive, anxiety, or somatic symptom-related disorders and completed the BRS, PHQ-9, GAD-7, and PHQ-15. Associations of BRS score with symptom outcomes and predefined pragmatic functional-burden indicators were assessed using multivariable linear, logistic, and negative binomial regression models; restricted cubic spline analyses were exploratory.

RESULTS

Among 522 screened adolescents, 447 were included. Across increasing BRS-score quartiles, mean PHQ-9 scores ranged from 17.1 ± 5.8 to 9.9 ± 5.2, GAD-7 scores from 13.4 ± 5.1 to 7.2 ± 4.5, and PHQ-15 scores from 12.2 ± 5.0 to 6.9 ± 4.3. The predefined marked functional impairment indicator ranged from 71.4% in Q1 to 30.6% in Q4 (P for trend <0.001). After adjustment, each 1-SD higher BRS score was associated with lower PHQ-9 score (β, -2.42; 95% CI, -3.02 to -1.82), GAD-7 score (β, -1.84; 95% CI, -2.38 to -1.30), PHQ-15 score (β, -1.50; 95% CI, -2.05 to -0.95), and functional impairment count (incidence rate ratio, 0.72; 95% CI, 0.64 to 0.82). Higher BRS score was also associated with lower odds of PHQ-9 score ≥10 (OR, 0.49; 95% CI, 0.36 to 0.66), GAD-7 score ≥10 (OR, 0.57; 95% CI, 0.43 to 0.75), PHQ-15 score ≥10 (OR, 0.61; 95% CI, 0.45 to 0.82), and marked functional impairment (OR, 0.53; 95% CI, 0.40 to 0.71). Exploratory spline analyses showed graded inverse associations but were not interpreted as identifying clinical thresholds.

CONCLUSION

Higher BRS score was concurrently associated with lower depressive, anxiety, and somatic symptom burden and fewer pragmatic indicators of functional burden in adolescent psychiatric outpatients. These cross-sectional findings do not establish causality, prognostic utility, or treatment-guiding value; longitudinal studies are needed to clarify temporal relationships and clinical utility.